Pain management in the home.

There is a major shift in responsibility for day-to-day pain management when a patient is to be cared for at home. What was primarily the responsibility of the nurse/physician team in the inpatient setting now becomes the responsibility of the patient and family. Poorly controlled pain affects not only the patient, but the family system as a whole. Successful pain management at home depends on a patient and family who feel reasonably confident in understanding the cause of the pain and in their ability to use the analgesics as prescribed (eg, around-the-clock doses and "rescue" doses), how to recognize and report changes in the pain site, character and severity, how to recognize and report adverse side effects from the analgesic prescribed, how to use non-drug measures to help relieve the pain, and how to access help and support on a 24-hour basis. Therefore, family education is key.